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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on August 14, 2006, at 17:58:13
In reply to Re: Is Kramer right?, posted by SLS on August 14, 2006, at 8:00:50
>Still, this is probably a matter of a >diminished rate of repair rather than its >complete absence as has been demonstrated by >the recovery of brain tissue seen with lithium >and antidepressant use.
If you inject BDNF direclty into the hippocampus of an animal, it acts virtually the same as an antidepressant does. Ie certain growth factors have direct antidepressant effect.
Some of the ideas about how antidepressants work has been speculation though. Yes they may increase neurogenesis, but the idea that they increase BDNF has not been consistenly shown, nor has it been directly shown that antidepressants actually make a depressed brain look more normal. In terms of antidepressants, tianeptine shows superior ability to protect against the consequences of unavoidable stress.
One study compared tianeptine to fluoxetine and concluded that while tianeptine provided neuroprotection against cortisol, fluoxetine provided no such effect.
I think there has been a lot of jumping on bandwagons, and assumptions. Some of these theories have been based on research, and other has just been filling in the blanks (assuptions).
I still think its too early to say that antidepressants actually do "reverse" the damamge caused by depression. They may grow new brain cells, but like manjii said, this is only part of the picture.
Linkadge
Posted by linkadge on August 14, 2006, at 18:01:02
In reply to Re: Is Kramer right? » Dinah, posted by SLS on August 14, 2006, at 10:49:27
>What does he claim is causing the damage to >begin with? Is this damage a product of normal >everyday living or is it abnormal and part of >the disease process?
I think his speculation is that two people could be subjected to the same stressfull event. One person may recover more poorly than the other. This single event may not be sufficiant to produce a depressive episode, but as the events accumulate, one person may become increasingly susceptable to even minor stressors.
Linkadge
Posted by linkadge on August 14, 2006, at 18:03:57
In reply to Scrupulosity » SLS, posted by Aphrodite on August 14, 2006, at 11:35:26
"he states that they've conducted studies that show people with in-born, clear rules of ethics and what is right and wrong are much more likely to develop depression."
Thats because you need a degree of "I just dont give a sh*t" to survive this world.
Linkadge
Posted by laima on August 14, 2006, at 18:04:54
In reply to Re: Optimistic part » laima, posted by linkadge on August 14, 2006, at 17:36:58
Yes, when she first got the tumour, people were sympathetic. Then she had surgery to have it removed, but it grew back. This happened several times now. Besides chemo, she was put on some nasty hormones, which made her look haggard. And next thing you know, numerous people who she thought were her friends were lecturing her about how she looks bad and should be taking better care of herself, no wonder the tumour was coming back, and so on. Mercy if she ever wanted to have a single beer or something (it was ok per her doctor)...people would react like she was chain-smoking crack.
I think you have a good observation- if people blame others for their illnesses, they get to somehow distance themselves or reassure themselves that it could never happen to them. Maybe they even get to excuse themselves from staying compassionate through a long-term difficult situation.
> >You'd be surprised- it's happened to a friend >of mine who is battleing brain tumours. It's >happened to her a lot- people directly and >indirectly accusing her of unhealthy living and >such.
>
> Wow, thats intense. I didn't think such people existed.
>
> Linkadge
>
Posted by linkadge on August 14, 2006, at 18:07:55
In reply to Re: Optimistic part » laima, posted by linkadge on August 14, 2006, at 17:36:58
I don't understand "better than well". When such an occurance happens how can one not stop and ask....is this safe??
I mean, illegal drugs make you feel better than well too.
I think it is evident (for many people who wanted on the "feeling better than well" bandwagon) that even this does not come without conseqence.
Do you know of anybody (who isn't bipolar) who still feels better than well after 20 years of taking the drug ?
Linkadge
Posted by linkadge on August 14, 2006, at 18:10:04
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:07:55
>Do you know of anybody (who isn't bipolar) who still feels better than well after 20 years of taking the drug ?
Because to be honest, I hear a lot of...at first the drug made me feel great, now all I want to do is sleep and shovel those little tiny white powdered donuts all day long.
p.s. I know I'm making no sence, but clearly I have many opinions about these drugs.
Linkadge
Posted by Phillipa on August 14, 2006, at 19:11:24
In reply to Re: Is Kramer right? » SLS, posted by linkadge on August 14, 2006, at 18:01:02
That's what happened to me. Love Phillipa
Posted by Phillipa on August 14, 2006, at 19:14:34
In reply to Re: Optimistic part » linkadge, posted by laima on August 14, 2006, at 18:04:54
Another reason doctors become doctors or nurses nurses to keep the bad illnesses away from them.Love Phillipa, ps it doesn't work
Posted by laima on August 14, 2006, at 20:30:38
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:07:55
"Better than well"-- a problem, for sure. I think Kramer or one of his critics came up with that phrase when they were so optimistic about the wonders of prozac that even non-depressed people wanted to take it- to feel "better than well". There were stories about perfectly well people asking their doctors for it in order to enhance their lives. It was obviously a controversial notion even then-and was the inspiration for tons of jokes. And remember, the drug was so new that the longer-term side effects and poop-out we know about now weren't known about then. And I personally don't know anyone who lasted 20 years doing well on prozac, either! Funny, it's reminiscent of the days when they thought cocaine was a wonder tonic...
> I don't understand "better than well". When such an occurance happens how can one not stop and ask....is this safe??
>
> I mean, illegal drugs make you feel better than well too.
>
> I think it is evident (for many people who wanted on the "feeling better than well" bandwagon) that even this does not come without conseqence.
>
> Do you know of anybody (who isn't bipolar) who still feels better than well after 20 years of taking the drug ?
>
>
> Linkadge
Posted by Phillipa on August 14, 2006, at 20:37:03
In reply to Re: Optimistic part » linkadge, posted by laima on August 14, 2006, at 20:30:38
True. So then in reality there are no meds that work for a great lenght of time? Love Phillipa
Posted by laima on August 14, 2006, at 20:45:49
In reply to Re: Optimistic part » laima, posted by Phillipa on August 14, 2006, at 20:37:03
> True. So then in reality there are no meds that work for a great lenght of time? Love Phillipa
Isn't that the million dollar question? :)
Posted by linkadge on August 14, 2006, at 20:47:02
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:10:04
Not to bring any undue insult to those little white powdered donuts.
Linkadge
Posted by linkadge on August 14, 2006, at 20:49:12
In reply to Re: Optimistic part » linkadge, posted by laima on August 14, 2006, at 20:30:38
So even if you felt better than well for a few years, and then poop out, guess what, you're going to feel worse than well for a while when it comes time to drop the drug.
Linkadge
Posted by linkadge on August 14, 2006, at 20:56:49
In reply to Re: Optimistic part » laima, posted by Phillipa on August 14, 2006, at 20:37:03
Its difficult to say. I think that people who have used these meds to treat genuine mental ilnesses probably get more mileage out of them.
Why? I think it comes down to homeostasis. The brain always tries to get to homeostasis which is proably the healthiest state of mind. If you feel better than well, your brain will start to try and counteract that. But if you are using the drug to move to a more normal state of mind, the brain might work to accomodate the drug rather than reject it.
It seems to be the case with stimulants too. When they're used for genuine attention problems, there is a case put forward that you don't see as much poop out.
Linkadge
Posted by Phillipa on August 14, 2006, at 21:28:34
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 20:56:49
Well to me this says that if I haven't ever achieved remission from an AD I may as well eat donuts? A lot cheaper. Love phillipa
Posted by laima on August 14, 2006, at 22:52:10
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 20:49:12
Yes!!! I wish someone told me that on day one!! I was prescribed loads of *weird* antidepressents with bad side effects after breaking up with a loser of a boyfriend when I was a college freshman (late 80's), and next thing you know I've got years of prescription use and am no better off. Probably worse off- right off the bat I can say at least one of the pre-prozac drugs I used briefly permanently changed my metabolism. Think of it- naive 17 year old breaks up with boyfriend and thinks life is therefore over- experts prescribe powerful mind altering drugs as the solution. Too bad they didn't try putting me into intensive counseling first. That's what should have happened. Before the antidepressents, I suffered mostly bouts of mild depression as well as normalish adolesent angst, but definately, my mood issues became much, much worse and more serious later on-after drugs, specifically, after prozac konked out on me some 10 years later. Similarly, my anxiety was much milder and more manageable before I became mixed up with long term use of strong benzodiazapines. There might be a cause and effect here- or there might not be. But regardless, while all of these drugs can useful and valuable of course, they are nothing to consider casually!This has been my experience, others might have different experiences and perspectives.
> So even if you felt better than well for a few years, and then poop out, guess what, you're going to feel worse than well for a while when it comes time to drop the drug.
>
> Linkadge
Posted by laima on August 14, 2006, at 22:59:56
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 20:49:12
I should be careful what I say- I've got a lot of muddled and mixed feelings on the topic of these drugs. Bottom line though, is that I think they are serious and not simple. Nothing to fool around with casually.
Posted by laima on August 14, 2006, at 23:03:11
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 20:56:49
> It seems to be the case with stimulants too. When they're used for genuine attention problems, there is a case put forward that you don't see as much poop out.I don't know- I was diagnosed with attention deficit disorder, it seemed to fit, ritalin helped tons--then it konked out after about 2 years. It devolved into inducing a state of passive fixation only.
Posted by laima on August 15, 2006, at 9:23:17
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:07:55
> I don't understand "better than well".
Now that I think of it, the term might have also been used to express just how well a depressed person could respond to the "miracle of prozac"...we'd have to go back and dig up the book and/or some of the old articles to verify.
Yes, a healthy dollop of reasonable and realistic skepticism doesn't hurt as we evaluate drug claims and hype!
Posted by Dinah on August 15, 2006, at 9:29:48
In reply to Re: Optimistic part » linkadge, posted by laima on August 14, 2006, at 23:03:11
I've been on Provigil for daytime sleepiness, and not only did I have to up the dose to the maximum my doctor prescribed but it's not working as well as it used to.
The worst part is that my baseline is now way worse than it was. If I skip a dose, I'm flat on my face snoring all day.
The same seems to be true with antianxiety medication. It used to be that anxiety was a problem, but now it's debilitating without the medications. And that was even true when I weaned off them.
I'm a great supporter of medications, but in some ways they scare me.
Posted by Dinah on August 15, 2006, at 9:31:27
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:07:55
I have to agree there.
I can only guess that Kramer wrote that book at the very beginning. Over time, surely the sexual side effects alone would cause otherwise happy enough people to decide they weren't better than well.
Posted by laima on August 15, 2006, at 10:37:16
In reply to Re: Optimistic part » laima, posted by Dinah on August 15, 2006, at 9:29:48
Sounds like your experiences are much like my own.
"Baseline"- I like your word choice- I'd definately say mine is lower now for the conditions I originally started using medications for, too. I don't know how to make sense of it all, what to think. Obviously the medications are very useful and have an important role for many people-including me at certain points- but at the same time, they scare me as well. I'm also a little concerned that some of them were originally prescribed a tad bit casually, in my own case, anyway. I'm miffed that I was constantly assured throughout my late teens and twenties that prozac was harmless and benign and perfectly safe to take for the rest of my life, etc., "as insurance". In retrospect, I wish I had been tapered off of it long before it pooped out. I wonder what would have happened. I'm particularly miffed that I was reassured many times by several doctors that it was perfectly fine to take klonopin for years--and now I've got a real problem with it, in that it's lost effectiveness, I crave it, and can't seem to cut it out for long. There have been times that I've even asked someone else to hold on to it for me due to my craving, and that is scary. I'm well into a taper plan right now...and it's going really good so far...but I'm still scared that it could turn right back around if something happens or if I give in and goof up. So now I've got these mood issues which are no longer terribley responsive to drugs, and I feel low on options. Not sure what to do- but I'm definately more interested in a healthy lifestyle and nutrition and so on than I used to be--not to mention Linkadage's neurogenesis list! Some of that stuff seems to really help, and I've developed a keen appreciation of how nuanced and delicate the brain is. (Though paradoxically, I am aware of the good news that that the brain can also be very resiliant and adaptable.) Definately, developing an aggressive excercise program has been particularly helpful to me for managing depression, anxiety, and to boost my energy levels and help with general fogginess; I also imagine I'm sweating away toxins (?). In any case, that habit is helping me to feel more empowered and less utterly helpless or victim-like. But the whole topic is confusing and frustrating.
> I've been on Provigil for daytime sleepiness, and not only did I have to up the dose to the maximum my doctor prescribed but it's not working as well as it used to.
>
> The worst part is that my baseline is now way worse than it was. If I skip a dose, I'm flat on my face snoring all day.
>
> The same seems to be true with antianxiety medication. It used to be that anxiety was a problem, but now it's debilitating without the medications. And that was even true when I weaned off them.
>
> I'm a great supporter of medications, but in some ways they scare me.
Posted by laima on August 15, 2006, at 10:39:26
In reply to Re: Optimistic part, posted by linkadge on August 14, 2006, at 18:07:55
> I think it is evident (for many people who wanted on the "feeling better than well" bandwagon) that even this does not come without conseqence.I keep thinking about how Freud was a cocaine enthusiast. General all purpose brain tonic and enegizer, indeed!
Posted by pulse on August 15, 2006, at 12:37:31
In reply to Re: Optimistic part » linkadge, posted by laima on August 15, 2006, at 10:39:26
true re: cocaine as an erengy wonder tonic. however, before that, we had morphine and the opium eaters touted ...and accepted as standard - do no harm - by many doctors for their patients. of course, we also had habituation set in for many, if not most.
now, we have bupe being used to treat depression.
are we, then, coming full circle?
i used to be such an advocate of psychotropic meds: ads, stabilizers, aps. now, i am fast becoming close to an anti-meds advocate. what the stabilzers, then the ads, did to my Gi tract is very scary. i feel for all those who have the same or other side-effects that, now, never go away.
i am in the camp that thinks the cortisol connection makes most sense, but i am extremely doubtful i will see meds based on that in my lifetime.
in gereral, it's scary when the docs, inventors, and researchers admit they don't really know for sure how any of our current meds work or why.
i'm not sure we are all that better off than freud's cocaine or the earlier morphine & opium. absinthe, anyone? i am NOT being facetious.
i apologize in advance if this possibly could have triggered anyone.
pulse
Posted by laima on August 15, 2006, at 13:07:18
In reply to Re: Optimistic part/ Possible Trigger(?) » laima, posted by pulse on August 15, 2006, at 12:37:31
Hopefully the drugs we have now are safer than the morphine, cocaine, halcion, etc of the past- at least there is some testing and questioning going on, for example. But it's enlightening to be aware of the history of there being a pattern of "new wonder cure or tonic without any side effects introduced, whoops, there are some side effects, on to the next one". We should obviously be careful about what we take and be as informed as possible, weigh the pros and cons of the possible risks of our medications in relation to our own circumstances. Also, I noticed that Dr.s and researchers are far more willing to admit that they often have no idea of how the drugs work than are the marketing teams.I think the medications can be very valuable and life-saving when used wisely and judiciously, but they are not casual!
Lots of neurotransmitters such as seratonin in the GI tract, by the way. Hence, for example, an ssri is not just active in the brain...
> true re: cocaine as an erengy wonder tonic. however, before that, we had morphine and the opium eaters touted ...and accepted as standard - do no harm - by many doctors for their patients. of course, we also had habituation set in for many, if not most.
>
> now, we have bupe being used to treat depression.
>
> are we, then, coming full circle?
>
> i used to be such an advocate of psychotropic meds: ads, stabilizers, aps. now, i am fast becoming close to an anti-meds advocate. what the stabilzers, then the ads, did to my Gi tract is very scary. i feel for all those who have the same or other side-effects that, now, never go away.
>
> i am in the camp that thinks the cortisol connection makes most sense, but i am extremely doubtful i will see meds based on that in my lifetime.
>
> in gereral, it's scary when the docs, inventors, and researchers admit they don't really know for sure how any of our current meds work or why.
>
> i'm not sure we are all that better off than freud's cocaine or the earlier morphine & opium. absinthe, anyone? i am NOT being facetious.
>
> i apologize in advance if this possibly could have triggered anyone.
>
> pulse
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Dr. Bob is Robert Hsiung, MD,
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